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May 1, 2016

Case Management: The Annual Meeting

The annual meeting is often a required component of case
management. Most treatment plans are only valid for one year and are required
to be renewed annually to continue services (and funding). Most Intellectual Disability (ID) waiver services also require authorization on an annual
basis. The annual meeting is a great time to get the entire support team
together and review progress and discuss any changes that need to be made. The support team often
consists of the parents/family/guardians as well as residential, day
support/vocational, and therapeutic consultation providers (if applicable). The
annual meeting can last anywhere from 1-3 hours depending on how many providers
are involved and the type of issues that need to be addressed. I outlined the order of a typical annual
meeting for ID and Mental Health case management services.

Annual Documentation

While not the most exciting part of the meeting, signing
annual documentation
is an important part of maintaining
accurate records. It’s also the most time consuming portion of the meeting. After
the meeting (and sometimes before the meeting) even more assessments
require and annual update. The primary forms of documentation signed annually
are:

Meeting Signature Page-
Everyone in attendance signs this page. It verifies that a meeting was held and
that the support team was present. It also verifies that the person receiving
services was present and a part of the planning process.

Release of
Information Authorizations- Release of information forms or consent forms
are signed to allow the case manager to communicate information to other
providers. These forms are important because the information exchanged often
contains sensitive medical and personal material and is protected under HIPPA laws.

Provider Choice Forms-
This form ensures that the clients are able to make informed decisions. They
verify that they were given a choice in service and service provider.

Program Rules (If Applicable) - Some service programs require a
form to be signed each year so that they are aware of what behaviors are
acceptable and what behaviors may lead to suspension or discharge from the
program.

Consent for Photos/Videos
(If Applicable) - Some service providers may post pictures and videos on
their websites and/or social media pages. It’s important to have this form
signed to ensure privacy.

Review of Human Rights

Review of the human rights is an important part of the annual
meeting. The case manager ensures that the client and/or authorized representative
or guardian understand their rights and are provided a hard copy for their
records. The general list of human rights includes:

1 - Right to be notified of their human rights. This is
required on an annual basis but can (and should) be provided anytime it is
requested.

2 – Right to treatment regardless of race, sex, religion, or
ability to pay.

3 – Right to confidentiality. Information cannot be
disclosed to other service providers without permission in the form of a signed
consent form. There are some exceptions in emergency situations.

4 – Right to Consent.
Some treatments may not be administered unless informed consent is
provided. This usually involves serious medical procedures and not typically
applicable to case management services.

5 – Right to dignity. Everyone has to the right to be treated
with respect. This also includes being protected from abuse and exploitation.

6 – Right to least restrictive treatment. Restriction of
freedom is always the last resort with the exception of emergency situations. The
goal is always to find alternatives that integrate the individual into his or
community as much as possible.

7 – Right to be compensated for work.

8 – Legal Rights. Individuals retain the basic rights of any
other citizen such as the right to vote, get married, etc.

9 – Right to Appeals and Hearings. Individuals have the
right to appeal any decisions that impact their services and benefits.

10 – Right to receive assistance from local and regional
human rights advocate. In situations that cannot be resolved at the agency level, a regional
advocate may be called to intervene and assist with resolving the complaint.

Health and Safety

Part of the meeting involves discussing any changes in
health status and medications. Updated information on the last physical and
dental appointments is also obtained at this time. A copy of the most recent
physical is often obtained at or soon after the meeting as well as an updated
list of medications.

Review Goals and Objectives

The review of the treatment plan goals and objectives, in my
opinion, is the most important part of the meeting. After all, the review and
renewal of the plan is the reason for the meeting. Each goal is discussed as a
team and removed or adjusted. Most goals that include monitoring of health and
safety are usually required and are never removed. New goals are added if the
client wants to achieve something new or additional service needs are
identified.

Progress/Lack of Progress

Goals that have been achieved are often changed or adjusted.
For example, a client who has a goal of obtaining employment may have that goal
adjusted to maintaining his/her employment. On the other hand, goals may be
deleted if they have been on the plan for several years and there has been no
progress. It’s a good chance that particular goal is unrealistic and should be
adjusted to something more attainable.

Satisfaction with Services

Of course last but not least, the case manager wants to
ensure that the individual, family, and/or legal guardian is satisfied with all
services. There should be at a minimum a proposed plan to address any unresolved
issues moving forward for the upcoming plan year.